2017-11-14T13:56:49-06:00 2016-12-31 450250958 EIDE BAILLY LLP 800 NICOLET MALL STE 1300 MINNEAPOLIS MN 554027033 990 2016-01-01 952082686 Ridgecrest Regional Hospital RIDG 7604463551 1081 N China Lake Blvd Ridgecrest CA 93555 James Suver CEO 7604463551 2017-11-10 1 Kim C Hunwardsen P00484560 6122536500 2017-11-10 209.243.15.107 2017-11-10 14:06:42 CS P 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 66CC91E6B7F11C4783FFFA5645E675327CB67316 2016 2017-02-10 21:41:12Z James Suver 1081 N China Lake Blvd Ridgecrest CA 93555 120352338 0 X www.rrh.org X 1965 CA Community-based organization that provides and promotes comprehensive quality healthcare for the people of the Southern Sierra Region. 11 6 986 71 0 0 68352 89651 111495311 117700944 127245 227286 -5315526 321096 106375382 118338977 0 0 0 0 45158559 49051954 0 0 0 53232458 57823322 98391017 106875276 7984365 11463701 145632853 154543765 80494869 77978378 65137984 76565387 X To be a community-based organization that provides and promotes comprehensive quality healthcare for the people of the Southern Sierra Region. 1 0 93153772 117956219 Ridgecrest Regional Hospital provides inpatient and outpatient care. Charity care is provided to qualified patients with minimum or no charge. Care accomplishments for the year are as follows: Number of Visits 63,355 Number of Patient Days 6,342 Home Health Visits 5,744 Hospice Routine Care Days 3,576SNF Resident Days 32,708Rural Health Visits 57,106Community Care Clinic Visits 35,584 93153772 1 1 0 1 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 175 0 1 986 1 0 0 0 0 0 1 1 0 0 0 0 X 11 6 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 CA X James Suver 7604993040 1081 North China Lake Blvd Ridgecrest CA 93555 Dana Lyons Chairperson 2.00 1.00 X X 0 0 0 Patricia Mullis Vice Chair 2.00 0.00 X X 0 0 0 Chris Ellis Secretary 2.00 0.00 X X 0 0 0 Michael Mower Treasurer (Jan-May) 2.00 0.00 X X 0 0 0 George Haslam Treasurer (Jun-Dec) 2.00 0.00 X X 0 0 0 Bud Biery Director(Jan-May) 2.00 0.00 X 0 0 0 Earl Ferguson MD Director/Physician(Jan-May) 3.00 0.00 X 91715 0 0 Harriet Luzinas-Smith Director 2.00 1.00 X 0 0 0 Lawrence Cosner MD Director/Physician 48.00 0.00 X 216171 0 36739 Don Zdeba Director 2.00 0.00 X 0 0 0 Gerald Baker Director 2.00 0.00 X 0 0 0 Walter Martin Director 2.00 0.00 X 0 0 0 Cornelis Vanderhoek MD Director/Physician(Jun-Dec) 7.00 0.00 X 41600 0 0 Margie Hannon Director 1.00 0.00 X 0 0 0 James Suver CEO 50.00 2.00 X 418716 0 23124 Lois Johnson CFO (Jan-Nov) 50.00 0.00 X 173791 0 17600 Sandra Gilliam Admin Patient Care 50.00 0.00 X 195697 0 21966 Healthy Desai Orthopedic Surgeon 40.00 0.00 X 659021 0 46400 Hope Zissos MD Family Practice Physician 40.00 0.00 X 290374 0 49843 Aisha Rollins Pediatrician 40.00 0.00 X 285725 0 19262 Kelvin Schimizu Pharmacy Director 40.00 0.00 X 202029 0 42360 James Antes Physician Assistant 42.00 0.00 X 220801 0 43551 2795640 0 300845 109 0 1 0 Comphealth Medical Staffing PO Box 972670 Dallas TX 75397 Staffing 656551 Ali R Lashgari MD 4741 Keswick CT San Diego CA 92130 Medical 579337 Eric D Frey 1325 Princeton St Santa Monica CA 90404 Medical 511837 Maurice Dusol Jr MD PO Box 1297 Ridgecrest CA 93555 Medical 509674 Ogrady Peyton 4441 Collections Center Dr Lock Bo Chicago IL 60693 Staffing 498910 62 77905 11746 89651 Net Patient Service Rev 622000 116355072 116355072 1345872 1345872 117700944 257500 257500 285358 220214 65144 65144 65144 48729 78943 -30214 -30214 -30214 1970156 1714204 255952 255952 118338977 117956896 0 292430 X 1193290 344684 848606 233864 233864 38235673 33660331 4575342 743641 647295 96346 5895864 5346237 549627 2749622 2397344 352278 542620 542620 128081 128081 24226774 21947730 2279044 4822469 4445025 377444 1346230 288095 1058135 398629 312901 85728 275812 205248 70564 2526581 2526581 7014197 6414238 599959 1889084 1889084 Medical Supplies 7660018 7624964 35054 Repair and Maintenance 3062398 1570677 1491721 Equipment Lease and Ren 464185 356983 107202 Provision for Bad Debts 348660 348660 3117584 2593831 523753 106875276 93153772 13721504 0 17454067 16956112 15444578 16432495 26308 15640 279550 15536 2010002 2706359 3025334 3231597 151190820 64664096 88941925 86526724 17371889 28158532 325770 1079200 175000 145632853 154543765 9310892 10836746 15304 23425 8726 49325 65779069 62843882 5380878 4225000 80494869 77978378 X 65137984 76565387 65137984 76565387 145632853 154543765 11463701 -36298 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 11000 0 0 0 11000 0 Part II-B, Line 1: The organization paid $4,000 to Citizens for Our Community College to support Measure J for funding capital projects across the three regional colleges. The organization paid $7,000 to Ridgecrest Yes to support Measure V to support funding for law enforcement and the repair of local streets. 0 1 X 2812140 2812140 111364119 38171541 73192578 590545 420224 170321 34745695 26072331 8673364 1678321 1678321 86526724 Estimated Third Party Payor Settlements 4050000 Malpractice Insurance Payable 175000 4225000 X 118174233 -36298 -348660 -384958 118559191 -220214 -220214 118338977 106746830 220214 220214 106526616 348660 348660 106875276 Part IV, Line 2b: Skilled nursing facility resident private monies maintained as a drawing account as required by Title 22 of the California Code of Regulations. Part X, Line 2: The Hospital is a nonprofit California corporation as defined in Section 501(c)(3) of the Internal Revenue Code and is generally exempt from both federal and state income taxes on related income pursuant to Section 501(a) of the same code. The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. Further, management believes that none of the current activities of the Hospital qualify for unrelated business income taxes. As a result, no provision for income taxes has been made in the accompanying financial statements. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 2d - Other Adjustments: Provision for Bad Debts Included in Expenses on Form 990 -348,660. Part XI, Line 4b - Other Adjustments: Rental Expenses Included in Expenses for Financials -220,214. Part XII, Line 2d - Other Adjustments: Rental Expenses Included in Revenue on Form 990 220,214. Part XII, Line 4b - Other Adjustments: Provision for Bad Debts Included in Revenue in Financials 348,660. 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 0 355063 355063 0.00330 29728119 12877888 16850231 0.15820 30083182 12877888 17205294 0.16150 68856 28852 40004 0.00040 129260 129260 0.00120 24500 24500 0.00020 222616 28852 193764 0.00180 30305798 12906740 17399058 0.16330 23150 23150 0.00020 1414 1414 0.00000 10361 10361 0.00010 234805 234805 0.00220 269730 269730 0.00250 1 348660 0 25562317 26605460 -1043143 X 1 1 1 1 Ridgecrest Regional Hospital 1081 N China Lake Blvd Ridgecrest CA 93555 www.rrh.org 120000186 X X X X Sleep study lab Ridgecrest Regional Hospital 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X http://rrh.org/info-resources X 1 16 1 http://rrh.org/cnastrategy2016/ 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X 1 X http://rrh.org/info-resources/ X http://rrh.org/info-resources/ X http://rrh.org/info-resources/ X X X X X 1 X 0 X X X X 1 X 0 0 Ridgecrest Regional Hospital Part V, Section B, Line 5: Input from the community was gathered through online and telephone interviews in March 2016. Individuals consulted consisted of 2 physicians, a psychologist, a public health nurse, other healthcare professionals, and a director of community outreach Ridgecrest Regional Hospital Part V, Section B, Line 11: Due to the timing of the approval for the 2016 CHNA and Implementation Strategy, the Hospital was not able to address in 2016 all of the needs identified in the 2016 CHNA. The following needs have been identified and will be addressed as follows:1) Substance & Alcohol Abuse: Mental Health Crisis Stabilization Unit withcapability to take patients in crisis for a 23 hour period2) Cancer: Affiliation with UC Davis Cancer Center; New oncology services in Outpatient Pavilion opens November 2017; Recruitment of onsite oncologist - 20173) Mental Health: Mental Health Crisis Stabilization Unit withonsite psychiatric nurses & telepsychiatrist; Continued Recruitment of onsite psychiatrist including pediatric psychiatry4) Heart Disease: Onsite non-invasive cardiologist5) Obesity & Nutrition: Senior exercise classes; Silver Sneakers; Chair Yoga; Diabetes classes; Healthy Eating classes6) Senior Health Services Including Dementia7) Women's Health ServicesThe following needs were identified, but due to limited funds and prioritization of needs they will not be addressed by RRH:1) Diabetes2) Smoking/Tobacco Use3) Asthma/Respiratory Disease4) Access to Specialists5) Medical Provider Recruitment6) Services for Low Income/MediCal Ridgecrest Regional Hospital Part V, Section B, Line 13h: Uninsured patients with incomes at or below federal poverty level are offered free care. Patients who are insured and have high medical costs (annual expenses exceed 10% of income) are eligible for discounted care. Monetary assets are considered in connection with eligibility for charity care, but not for discounted care. Ridgecrest Regional Hospital Part V, Section B, Line 16j: Financial packets are provided to each self-pay patient, in addition to: a website reference to the policy; an onsite financial counselor made available to patients; and posting of the policy in all patient access areas. 18 1 - Bella Serra Skilled Nursing Facility 1131 N China Lake Blvd Ridgecrest CA 935553131 Skilled Nursing Facility 2 - Ridgecrest Regional Hospital Rural Healt 1111 N China Lake Blvd Ridgecrest CA 93555 Rural Health Clinic 3 - China Lake Community Care Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Community Care Clinic 4 - Ridgecrest Regional Hospital Urgent Care 1111 N China Lake Blvd Ridgecrest CA 93555 Urgent Care 5 - Ridgecrest Regional Hospital Orthopedic 1041 N China Lake Blvd Ridgecrest CA 93555 Orthopedic Clinic 6 - Center Professional Pharmacy 1109 N China Lake Blvd Ridgecrest CA 93555 Center Professional Pharmacy 7 - Ridgecrest Regional Hospital Home Health 1653 N Triangle Dr Ridgecrest CA 93555 Home Health 8 - China Lake Dermatology 1011 N China Lake Blvd Ridgecrest CA 93555 Dermatology Clinic 9 - China Lake Gastroenterology 1011 N China Lake Blvd Ridgecrest CA 93555 Gastroenterology Clinic 10 - Ridgecrest Regional Hospital Hospice 1653 N Triangle Dr Ridgecrest CA 93555 Hospice 11 - Ridgecrest Regionl Hosp Internist Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Internist Clinic 12 - China Lake Surgical Clinic 1041 N China Lake Blvd Ridgecrest CA 93555 Surgical Clinic 13 - Ridgecrest Regional Hosp Living Assist 1653 N Triangle Dr Ridgecrest CA 93555 Living Assistance Program 14 - China Lake Specialty Clinics-OB Clinic 1011 N China Lake Blvd Ridgecrest CA 93555 OB Clinic 15 - Trona Rural Health Clinic 82820 Trona Rd Trona CA 93562 Rural Health Clinic 16 - Ridgecrest Regional Hosp Occup Health 409 Drummond Ave Ridgecrest CA 93555 Occupational Health 17 - Ridgecrest Regional Hosp Senior Services 417 Drummond Ave Ridgecrest CA 93555 Senior Services Part I, Line 3c: Uninsured patients with incomes at or below federal poverty level are offered free care. Patients who are insured and have high medical costs (annual expenses exceed 10% of income) are eligible for discounted care. Monetary assets are considered in connection with eligibility for charity care, but not for discounted care. Part I, Line 7: Lines 7a and 7b were converted to cost based on an average ratio of costs to gross charges. Lines 7e, 7f, and 7i were based on actual expenses. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 348,660. Part II, Community Building Activities: Activities include: Provide free office space for health organizations within the community, community collaboration through community health improvement advocacy, physician recruitment to ensure basic care is available locally, sponsor annual health fair with free and low cost health screening, collaborate with other emergency services on disaster and emergency preparedness, and provide wellness fairs for the Navy Base and Water District. Part III, Line 2: Patient A/R consists of amounts owed by various governmental agencies, insurance companies and private patients. The Hospital manages its receivables by regularly reviewing the accounts, inquiring with respective payors as to collectability and providing for allowances on their accounting records for estimated contractual adjustments and uncollectible accounts. Bad debt is reported at charges per the audited financials. Part III, Line 4: The footnote to the organization's financial statements that describes bad debt expenses is located in footnote 1 on page nine and ten of the attached financial statements. Part III, Line 8: One hundred percent of any shortfall should be treated as community benefit. A facility must be able to recover its costs in order to continue to provide quality care to Medicare patients and the community as a whole. Services are provided to patients under the Medicare program knowing that not all costs associated with providing these services will be recovered. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit.Medicare allowable costs of care are based on the Medicare cost report. The Medicare cost report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. Part III, Line 9b: Prior to discharge, patients who fall under the collection practices receive a financial application packet to complete with a staff member's business card attached. They are instructed to call if they need assistance in completing the financial application, which will determine their eligibility for assistance. If eligible, they may qualify for possible charity care allowance.RRH does not send patients to collections until 120 days after the date of the invoice. If the patient begins the financial assistance process they bring the account back from collections. Part VI, Line 2: In addition to the community health needs assessment Ridgecrest uses patient satisfaction surveys to assess the health care needs of the community, along with conducting blood draws at health fairs. The HR administrator serves on the local Rotary as well to network with other community leaders. Part VI, Line 3: Signs are posted in registration areas informing patients of assistance with their bills and includes citing a phone number to call for assistance in this area. Self pay patients are sent a packet of information regarding financial assistance programs. Part VI, Line 4: Rural California Desert Community located in Kern County; more than 50 miles from next nearest hospital. The population is approximately 38,000 and approximately 6.8% of that population is uninsured. Part VI, Line 5: Ridgecrest Regional Hospital's governing body is comprised of persons who reside in the Organization's primary service area. The Hospital applies any surplus funds to improve the Facility and equipment to improve patient care. The Hospital also extends medical staff privileges to other qualified physicians in the community.Ridgecrest Regional Hospital holds an annual health fair for the community, wherein vendors offer information and services related to health and wellness, along with free and reduced-priced blood screenings. A health fair at China Lake Naval Base is also held, wherein reduced-price blood screenings, free blood pressure checks, and information on health and nutrition are provided. Ridgecrest Regional Hospital offers free blood pressure checks and veteran benefit information for Veteran's Standdown, an event held to provide benefits and services to veterans. Ridgecrest Regional Hospital offers 12 weekly classes to seniors within the community, free of charge, that promote exercise, as well as senior group services catered to finding joy and happiness in life while socializing and building support systems. The following support groups are offered free of charge to the community: Grief, Caregiver, Alzheimer's Caregiver, Better Breathers, and Diabetes. The Wellness Resource Center provides free access to information on health and nutrition, including videos and books. In addition, the Wellness Resource Center provides nutrition programs and presentations to schools, churches, businesses, parents, and other organizations. Hospital tours are provided to students and other groups within the community. An annual publication, mailed to all homes within the community and available at Ridgecrest Regional Hospital, lists all services and providers at Ridgecrest Regional Hospital. A brochure provides information for local mental health services. Connected, a quarterly publication, focuses on Ridgecrest Regional Hospital's services, along with health tips and information. Part VI, Line 6: N/A X X X X 0 0 0 0 0 0 0 0 0 Lawrence Cosner MD Director/Physician 215921 0 0 0 250 0 0 0 36799 0 252970 0 0 0 James Suver CEO 288941 0 117630 0 12145 0 10600 0 12584 0 441900 0 0 0 Lois Johnson CFO (Jan-Nov) 156422 0 17119 0 250 0 6326 0 11334 0 191451 0 0 0 Sandra Gilliam Admin Patient Care 185568 0 9658 0 471 0 7300 0 14726 0 217723 0 0 0 Healthy Desai Orthopedic Surgeon 658933 0 0 0 88 0 10338 0 36122 0 705481 0 0 0 Hope Zissos MD Family Practice Physician 251647 0 38554 0 173 0 10554 0 39349 0 340277 0 0 0 Aisha Rollins Pediatrician 285638 0 0 0 87 0 7220 0 12102 0 305047 0 0 0 Kelvin Schimizu Pharmacy Director 187398 0 14130 0 501 0 3071 0 39349 0 244449 0 0 0 James Antes Physician Assistant 220620 0 160 0 21 0 6812 0 36799 0 264412 0 0 0 Gul Anwar Former Highly Compensated Employee Personal X 40000 15640 0 0 1 15640 Mark Mower Family of Treasurer Michael Mower 104945 Wages 0 James Gilliam Family of Key Employee Sandy Gilliam 43680 Wages 0 Kathryn Garcia Family of Board Member Lawrence Cosner 56285 Wages 0 Mary Rusher Family of Treasurer Michael Mower 28954 Wages 0 Form 990, Part III, line 2 A retail pharmacy was established in addition to the current in-patient pharmacy that was already in place. Form 990, Part VI, Section A, line 6 There is one class of members, Corporate Members and an honorary nonvoting group of individuals called Emeritus Members who are appointed by the Board of Directors and have limited rights. Corporate Membership is limited to thirty (30) persons, who must reside in the Hospital service area (as such service area is determined by the Board of Directors) who are elected to membership by a vote of the Corporate Members present or represented at a meeting of Corporate Members. Form 990, Part VI, Section A, line 7a The Corporate Members have the right to elect the members of the Board of Directors. Form 990, Part VI, Section A, line 7b Under the bylaws, the Corporate Members have the right to: elect the members of the Board of Directors; fill a vacancy on the Board of Directors; and ratify the bylaws that have been approved by the Board of Directors. In addition, members have certain rights granted pursuant to the California Nonprofit Public Benefit Corporation Act including the right to: remove a director; approve most amendments to the Articles of Incorporation; approve a sale of assets not in the usual and regular course of its business; merge with another entity; and dissolve. Form 990, Part VI, Section A, line 8b The organization does not have any committee with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the Board of Directors via electronic distribution prior to filing with the IRS. Form 990, Part VI, Section B, line 12c There is annual disclosure on conflict of interest policy for directors, officers, medical staff officers, and administrative employees, and corporate members. Compliance with conflict of interest policy is monitored by the CEO. Any noted conflicts are reviewed and discussed by the Board of Directors. The individual with the potential conflict must abstain from the discussion and vote on the potential conflict. Form 990, Part VI, Section B, line 15 Compensation for the CEO was determined by a compensation committee of the Board of Directors using compensation comparison provided by HASC. For other officers, the HASC salary survey is used to comply with prohibition from direct solicitation of salary information due to anti-trust regulations. Form 990, Part VI, Section C, line 19 All public documents are made available upon request. Form 990, Part IX, line 11g Other Purchased Services: Program service expenses 7,963,134. Management and general expenses 1,652,086. Fundraising expenses 0. Total expenses 9,615,220. Professional Fees: Program service expenses 13,419,875. Management and general expenses 3,000. Fundraising expenses 0. Total expenses 13,422,875. Other Fees: Program service expenses 564,721. Management and general expenses 623,958. Fundraising expenses 0. Total expenses 1,188,679. RRH Development Foundation 1081 N China Lake Blvd Ridgecrest CA 93555 464181603 Raising Hospital Capital Equipment Funds CA 501(c)(3) Line 10 Ridgecrest Regional Hospital 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 RRH Development Foundation C 77905 General Ledger